‘A ticking time bomb’: Coronavirus spread in Africa

With the Covid-19 threatening the healthcare system, people in Mnarani, Kilifi, are worried about their children. According to the report, 17 toddlers died after exhibiting symptoms which included difficulty in breathing, a fever, general body weakness, and a dry mild cough.

One of the parents Zacharia Opollo, lost his daughter, Miriam Ndede (one-and-a-half years old) in under 24 hours of falling sick. Narrating his disheartening story, the father revealed that his daughter started experiencing difficulty in breathing on the night of March 3, and he rushed her to a private facility in Kilifi where she was treated and discharged.

However, her symptoms worsened and at 2 a.m. he was back at the hospital. After several inconclusive tests, he decided to rush her to Malindi sub-County Hospital where she was immediately admitted to the High Dependency Unit. Okollo went on to reveal that his daughter passed on at 4 a.m. and that the doctors didn’t seem to have an answer as to what exactly had brought about the sudden and unexpected demise. Her medical records show that she had a two to four-day history of illness. She had started treatment which did not alleviate her symptoms. By the time she was getting to Kilifi County Hospital, she was in shock as was confirmed by her blood tests. She did not have malaria either.

Sixteen other parents have been in the same situation in just over 3 weeks. Alfred Ouma stated that he lost his 8-month-old daughter under the exact same conditions.”She died in less than 24 hours and the diagnosis they gave was pneumonia,” he narrated. However, he claims that she did not respond to any of the medication and that by the time she got to Kilifi County Hospital, she was in shock and soon passed away.

“Over the last two weeks, we have seen children with similar presentations of sickness,” a healthcare worker who sought anonymity said. At least three children had died a few minutes after getting to the hospital, he said.

“We are wondering what’s happening,” another healthcare worker said. “We know certainly that it is pneumonia but we don’t know why it is happening now.”

So far, the official numbers seemed to suggest that Africa, home to more than 1 billion people, has been lucky. The interactive map of reported COVID-19 cases run by Johns Hopkins University shows big red blobs almost everywhere—except Africa. But now the numbers are rising quickly.

And although Africa’s handling of the pandemic has received scant global attention so far, experts worry the virus may ravage countries with weak health systems and a population disproportionately affected by HIV, tuberculosis (TB), and other infectious diseases. “Social distancing” will be hard to do in the continent’s overcrowded cities and slums.

The focus of African COVID-19 surveillance has been at countries’ points of entry, and testing has targeted people with a recent travel history to outbreak areas abroad. However, screening passengers for fever has shown to be largely ineffective, because it doesn’t catch people still in their incubation phase—up to 14 days for COVID-19. It also won’t detect cases that occur in African communities. I do think that cases are slipping through the net. There is an urgent need to investigate and address this point.

Sub-Saharan Africa has one major advantage when it comes to COVID-19: Its average age is the lowest in the world.  Only 3% of sub-Saharan Africa’s population is older than 65, compared with about 12% in China. Some scientists also think the high temperatures in many African countries may make life harder for the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2.

Many other factors could make the pandemic worse in Africa. It will be hard to apply the interventions that have beaten back the virus to very low levels in China and have helped South Korea keep the epidemic more or less in check. Several countries have already introduced rules to thwart spread; Rwanda announced it would close places of worship, schools, and universities after its first case. But social distancing may be impossible in crowded townships, and it’s not clear how confinement would work in African households that are a simply a one room abode. How do you protect the elderly? How can you tell village populations to wash their hands when there is no water, or use gel to sanitize their hands when they don’t have enough money for food? I’m afraid it will be chaos.

And many African countries simply don’t have the health care capacity to look after severely ill COVID-19 patients. A 2015 paper found that Kenya, a nation of 50 million people that declared its first case a few days ago, only had 130 intensive care unit beds and only about 200 specialized intensive care nurses. Many other countries face similar constraints.



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